New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

O'Reilly Automotive Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for O'Reilly Automotive O'Reilly Automotive, primarily reliant on its internal health benefits system, partners with various healthcare providers and insurers to offer health plans to its employees. While specific provider names can vary by location and plan type, O'Reilly typically collaborates with major insurance firms that participate in the Affordable Care Act (ACA) marketplace. Potential Healthcare Cost Increases for O'Reilly Automotive in 2026 As the healthcare landscape shifts, O'Reilly Automotive employees and retirees should prepare for potentially significant increases in their healthcare costs in 2026. Factors such as the expected expiration of enhanced federal ACA premium subsidies may lead to out-of-pocket premiums surging by over 75% for many policyholders. Coupled with aggressive rate hikes from insurers-some states reporting increases of 60% or more-employees may encounter substantial financial strain when seeking medical coverage. This perfect storm of escalating premiums and reduced federal support underlines the importance of proactive budgeting and planning for healthcare expenses in the coming year. Click here to learn more

'O'Reilly Automotive employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'O'Reilly Automotive employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
Practical steps O'Reilly Automotive professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. ¹

“It feels like a second mortgage to pay this premium.”

Profile: A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed: Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure: They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response: We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile: A single client in her early 60s undergoing ongoing medical treatment.

What changed: Without enhanced subsidies, her premiums nearly tripled.

Decision pressure: Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response: We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile: A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed: Without subsidies, their net premiums are expected to rise sharply.

Decision pressure: Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response: We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile: An independent contractor in their 20s with minimal expected medical use.

What changed: Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure: Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response: We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. ²

How The Retirement Group Supports O'Reilly Automotive Professionals

For O'Reilly Automotive employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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Sources:

1. Cox, Cynthia, et al. “ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Expire.” Kaiser Family Foundation (KFF) , 2025, pp. n.p., https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/ .
2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
Other resources:
1. “When Can You Get Health Insurance? | Dates & Deadlines.” HealthCare.gov , U.S. Centers for Medicare & Medicaid Services, n.d., https://www.healthcare.gov/quick-guide/dates-and-deadlines/ .
2. Publication 969: Health Savings Accounts and Other Tax-Favoured Health Plans. Internal Revenue Service, 2024, pp. 8–9, https://www.irs.gov/pub/irs-pdf/p969.pdf .
3. “Silver vs. Bronze Plan Selection: Cost-Comparison Scenarios.” Centers for Medicare & Medicaid Services (CMS) , 23 Dec. 2024, pp. 1–3, https://www.cms.gov/files/document/silver-vs-bronze-cost-comparison-scenario-resource.pdf .
4. Murphy, Tom. “Expect Health Insurance Prices to Rise Next Year, Brokers Say.” AP News , Associated Press, 24 Aug. 2025, https://apnews.com/article/health-insurance-drug-costs-2026-rates-c4d865ec09c7088ecc6b55dc520f3566 .

What is the 401(k) plan offered by O'Reilly Automotive?

The O'Reilly Automotive 401(k) plan is a retirement savings plan that allows employees to save a portion of their paycheck before taxes are deducted.

Does O'Reilly Automotive offer a company match for the 401(k) contributions?

Yes, O'Reilly Automotive offers a company match for employee contributions to the 401(k) plan, helping employees to grow their retirement savings.

How can employees at O'Reilly Automotive enroll in the 401(k) plan?

Employees at O'Reilly Automotive can enroll in the 401(k) plan through the company’s benefits portal or by contacting the HR department for assistance.

What is the eligibility requirement for O'Reilly Automotive's 401(k) plan?

Employees must be at least 21 years old and have completed a specified period of service to be eligible for O'Reilly Automotive's 401(k) plan.

Can employees at O'Reilly Automotive take loans against their 401(k) savings?

Yes, O'Reilly Automotive allows employees to take loans against their 401(k) savings, subject to certain conditions and limits.

What investment options are available in the O'Reilly Automotive 401(k) plan?

The O'Reilly Automotive 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and company stock.

How often can employees change their contribution amounts for the O'Reilly Automotive 401(k) plan?

Employees at O'Reilly Automotive can change their contribution amounts at any time, subject to the plan's guidelines.

Is there a vesting schedule for the company match in O'Reilly Automotive's 401(k) plan?

Yes, O'Reilly Automotive has a vesting schedule for the company match, which determines how much of the match employees will retain if they leave the company.

What happens to the 401(k) savings if an employee leaves O'Reilly Automotive?

If an employee leaves O'Reilly Automotive, they can roll over their 401(k) savings into another retirement account, cash out, or leave the funds in the O'Reilly Automotive plan if allowed.

Can employees at O'Reilly Automotive contribute to their 401(k) on a pre-tax and Roth basis?

Yes, O'Reilly Automotive allows employees to choose between pre-tax contributions and Roth contributions for their 401(k) savings.